In-person collaboration between radiologists and acute care surgeons can lead to changes in patient management, according to a recent study published by the Journal of the American College of Radiology.
Matthew S. Davenport, MD, department of radiology at the University of Michigan Health System in Ann Arbor, Mich., and colleagues wrote that in-person collaborations have specific advantages over conferences that take place over the telephone or online.
“Research on health care team effectiveness has shown that member diversity in training and experience (eg, surgeons and radiologists) underlies improvement in team effectiveness,” the authors wrote. “Furthermore, it has been shown that geographically collocated teams that engage in face-to-face interaction experience lower levels of conflict than teams relying solely on electronic communication.”
To explore this idea, Davenport et al. scheduled in-person meetings between representatives from an institution’s on-call acute care surgery team and its abdominal radiology team to review the care of various patients.
Cases were reviewed one at a time in these meetings; the attending surgeon would begin by stating his or her current diagnoses and treatment plan, and the radiologists would then perform a comprehensive imaging review, answering any questions the surgeons may have along the way.
Once the discussion about that patient was complete, the attending surgeon again went over the diagnoses and treatment plan. Any changes that came as a result of the radiologist’s input were recorded in detail.
Overall, from Jan. 29, 2015, to Dec. 10, 2015, 100 patients were reviewed in 21 in-person meetings. The meetings led to changes in surgeons’ diagnostic impressions in 43 of the 100 cases. Strangely enough, the meetings led to changes in the surgeons’ treatment plans in the exact same number of cases: 43.
However, the meeting led to actual changes in the patient’s operative plan in just 19 of the 100 cases.
“Although logistically more challenging to implement than a traditional ‘tumor board’ on a routine schedule, the results of our initiative suggest that such a model may be worth the effort,” the authors wrote.
Davenport and colleagues noted that arranging these meetings did take up a fair amount of time for both the surgeons and the radiologists, but it seems to have been well worth the effort.
“Each meeting necessitated approximately 1 to 2 hours of attending radiologist effort and approximately 1 hour of effort from all other attendees,” the authors wrote. “However, there was multidisciplinary recognition of the apparent impact this activity was having on patient care and heightened sentiments of teamwork and camaraderie. Despite the nonremunerated effort required to perform this activity, it has become a routine part of clinical care in our hospital.”
The authors added that their study did have limitations. For instance, some of the changes in impressions and patient management may have occurred even without the in-person meetings; there’s no way to truly know for sure. In addition, these results reflect one single institution and may not represent other physicians in other institutions.